Cenate, Sherry A 37f
NEW YORK STATE DEPARTMENT OF HEALTH r '
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Sherry Pauline Cenate Female
Date of Death Age If Veteran of U.S. Armed Forces,
May 2, 2015 70 War or Dates
Place of Death Hospital, Institution or
,r City, Town or Village Argyle Street Address Washington Center
Manner of Death X❑ Natural Cause ❑ Accident I I Homicide ❑ Suicide ❑ Undetermined ❑ Pending
Circumstances Investigation
� k.
Medical Certifier Name Title
Edit Masaba, MD Dr.
_ Address
ry , 35 Gilbert Street Greenwich, NY 12834
Death Certificate Filed District Number Register Number
'`vim City, Town or Village Argyle S'Is t> .23
❑Burial Date Cemetery or Crematory
May 5, 2015 Pine View Crematory
❑Entombment Address
®Cremation Quaker Road Queensbury,NY 12804
11 Date Place Removed
❑ Removal and/or Held
and/or Address
z. Hold
Date Point of
❑Transportation Shipment
by Common Destination
-` Carrier
❑ Disinterment
Date Cemetery Address
:gym.;
❑ Reinterment Date Cemetery Address
,tlirett
Permit Issued to
Registration Number
-k Name of Funeral Home M. B. Kilmer Funeral Home-Argyle 01077
' Address
7: 123 Main St., Argyle NY 12809
c---,:-.-.--
:II Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
Address
Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 515/306 Registrar of Vital Statistics ppt f Y\ic ktA,40701
(signature)
District Number 515 0 Place GUI Li. �yy
Li ' 7
certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
;' Date of Disposition 05/05/2015 Place of Disposition Quaker Road Queensbury,NY 12804
(address)
(section) (lot number) (grave number)
Name of Sexton or Person in Charge o Premises %,,,t'L., �....�q-
1ease pant)
s Signature Title eig.."+► , ,(
(over)
DOH-1555 (02/2004)